Vascular depression: an early warning sign of frailty.

TitleVascular depression: an early warning sign of frailty.
Publication TypeJournal Article
Year of Publication2013
AuthorsPaulson, D, Lichtenberg, PA
JournalAging Ment Health
Date Published2013
ISSN Number1364-6915
KeywordsActivities of Daily Living, Aged, Aged, 80 and over, Aging, Cerebrovascular Disorders, depression, Disabled Persons, Female, Follow-Up Studies, Frail Elderly, Geriatric Assessment, Health Status, Humans, Incidence, Logistic Models, Male, Prevalence, Psychiatric Status Rating Scales, Risk Factors, Socioeconomic factors, United States

OBJECTIVES: Frailty is a common geriatric disorder associated with activities of daily living (ADL) impairment, hospitalization, and death. Phenomenological evidence suggests that late-life depression (Katz, 2004 ), particularly vascular depression, may be a risk factor for frailty. This study tests that hypothesis.

METHODS: We identified a sample of stroke-free women over the age of 80 from the Health and Retirement Survey. The sample included 984 respondents in 2000 (incidence sample). Of these, 459 were non-frail at baseline and still alive in 2004 (prevalence sample). Frail respondents experienced at least three of the following: wasting, exhaustion, weakness, slowness, and falls. Vascular depression was represented using two dummy variables. The first represented respondents with either high cerebrovascular burden (CVB; at least two cerebrovascular risk factors) or probable depression (score ≥3 on the 8-item Center for Epidemiological Studies Depression Scale (CES-D)), and the second represented respondents with both high CVB and probable depression.

RESULTS: At baseline, the prevalence of frailty was 31.5%. Over four years the incidence of frailty was 31.8%. After controlling for age, education, ADL and IADL disability, arthritis, pulmonary disorders, cancer, and self-rated health, respondents with either high CVB or probable depression were more likely to be frail at baseline, and those with both were at even higher risk. Of those who were not frail at the 2000 wave, respondents who reported both high CVB and probable depression were more likely to become frail by 2004.

DISCUSSION: These findings suggest that vascular depression is a prodrome for frailty.

User Guide Notes

Endnote Keywords

activities of daily living/depression/cerebrovascular burden/frailty

Endnote ID


Alternate JournalAging Ment Health
Citation Key7741
PubMed ID22724516
PubMed Central IDPMC3492543
Grant ListP30 AG015281 / AG / NIA NIH HHS / United States
T32 AG000275 / AG / NIA NIH HHS / United States
T-32 AG00275-06 / AG / NIA NIH HHS / United States